Posterior talar process fracture
Citation, DOI, disclosures and article data
Citation:
Goel A, Glick Y, Yap J, et al. Posterior talar process fracture. Reference article, Radiopaedia.org (Accessed on 17 Jan 2025) https://doi.org/10.53347/rID-35121
Permalink:
rID:
35121
Article created:
23 Mar 2015,
Ayush Goel
Disclosures:
At the time the article was created Ayush Goel had no recorded disclosures.
View Ayush Goel's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Yaïr Glick had no financial relationships to ineligible companies to disclose.
View Yaïr Glick's current disclosures
Revisions:
17 times, by
11 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Fracture of Stieda process
- Shepherd fractures
- Cedell fractures
- Posterior talar process fractures
- Stieda process fracture
- Stieda process fractures
- Fracture of the Stieda process
- Stieda process fracture of ankle
Posterior talar process fractures may involve the medial or lateral tubercle of the posterior process of the talus. The posterior talofibular ligament attaches to the lateral tubercle and flexor hallucis longus runs between these two tubercles. The unfused ossification center of the lateral tubercle forms the os trigonum.
On this page:
Terminology
A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. An elongated lateral tubercle of the posterior process of the talus is referred to as a Stieda process, so occasionally these fractures are described as Stieda process fractures.
A Cedell fracture is a fracture of the medial tubercle of the posterior process.
Fractures of the entire posterior process of the talus are extremely rare.
Pathology
Mechanism of injury
injury to lateral tubercle is caused by inversion or extreme equinus
injury to medial tubercle is uncommon and is caused by forced dorsiflexion and pronation
Radiographic features
Plain radiograph
Lateral process fractures are best visualized on lateral projections. The os trigonum may be mistakenly identified as a fracture on plain radiograph.
CT
Best imaging modality for identifying posterior process fractures. CT is indicated when clinical suspicion is high but radiographs are negative.
Treatment and prognosis
Short leg cast or ankle brace is used until signs of union appear. If there is non-union, then the treatment is excision of the fragment.
References
- 1. Ahmad R, Ahmed SM. Fracture of the posterior process of the talus: an unusual injury. Emerg Med J. 2007;24 (12): 867. doi:10.1136/emj.2006.045609 - Free text at pubmed - Pubmed citation
- 2. Blanchette MA, Grenier JM. Fracture of the lateral tubercle of the posterior talar process caused by a rock-climbing fall: a case report. J Can Chiropr Assoc. 2014;58 (3): 286-90. Free text at pubmed - Pubmed citation
- 3. O'Loughlin P, Sofka CM, Kennedy JG. Fracture of the medial tubercle of the posterior process of the talus: magnetic resonance imaging appearance with clinical follow-up. HSS J. 2009;5 (2): 161-4. doi:10.1007/s11420-009-9113-z - Free text at pubmed - Pubmed citation
- 4. Majeed H, McBride DJ. Talar process fractures: An overview and update of the literature. (2018) EFORT open reviews. 3 (3): 85-92. doi:10.1302/2058-5241.3.170040 - Pubmed
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